{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T06:20:16Z","timestamp":1790317216671,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,8,24]],"date-time":"2020-08-24T00:00:00Z","timestamp":1598227200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Ischaemic diabetic heel ulcers are difficult to treat and prognosis is often guarded. The aim was to document our outcome of treating heel ulcers following revascularization in a predominantly diabetic Asian cohort presenting with chronic limb threatening ischaemia from Singapore. Retrospective cohort study (n = 66, 66 limbs) over a 5\u2010year period. Data were collected from hospital electronic health records. Outcomes included time to healing, amputation free survival (AFS), and mortality. Minimum follow\u2010up period was 6 months. Multivariate regression analysis was performed to look for factors associated with poor outcome. Mean age was 67.4\u2009\u00b1\u20098.8\u2009years. 62\/66 (93.9%) were diabetics. Mean wound size at presentation was 3.6\u2009\u00b1\u20092.3 cm. Mean Wound, Ischaemia, Foot Infection (WIFI) score was 5\u2009\u00b1\u20091.6. 12\/66 (18%) patients had a patent posterior tibial artery pre\u2010operatively. Straight line flow was restored in only 31\/66 (46.9) patients but 47\/66 (71.2%) had successful limb salvage. Median time to wound healing was 90.0 (IQR 60\u2010180) days. A median of 1 (IQR 0\u20102) wound debridement was required. Patients who underwent negative pressure dressing (23\/66; 34.8%) required a median of 26 (IQR 13\u201033) cycles to achieve healing. Amputation free survival (AFS) was 72% and 68% at 6\u2010 and 12\u2010months, respectively. Mortality rate was 16.7% and 19.7% at 6\u2010 and 12\u2010months, respectively. Low albumin level and initial Rutherford class were independent predictors of worse 6\u2010month AFS. Outcomes of heel ulcers post revascularisation may not be as poor as previously described. Persistent attention to wound care with multidisciplinary effort is needed for optimal healing.<\/jats:p>","DOI":"10.1111\/iwj.13493","type":"journal-article","created":{"date-parts":[[2020,8,25]],"date-time":"2020-08-25T11:19:57Z","timestamp":1598354397000},"page":"2010-2018","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Heal or no heel: Outcomes of ischaemic heel ulcers following lower limb revascularization from a multi\u2010ethnic Asian Cohort in Singapore"],"prefix":"10.1111","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7119-4178","authenticated-orcid":false,"given":"Yun Le","family":"Linn","sequence":"first","affiliation":[{"name":"Department of Vascular Surgery Singapore General Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sze Ling","family":"Chan","sequence":"additional","affiliation":[{"name":"Health Services Research Center, SingHealth  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shereen Xue Yun","family":"Soon","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery Singapore General Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charyl Jia Qi","family":"Yap","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery Singapore General Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mervin Nathan Han Hui","family":"Lim","sequence":"additional","affiliation":[{"name":"Yong Loo Lin School of Medicine, National University of Singapore  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing Wei Shaun","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery Singapore General Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tze Tec","family":"Chong","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery Singapore General Hospital  Singapore"},{"name":"Duke\u2010NUS Graduate Medical School  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8524-7912","authenticated-orcid":false,"given":"Tjun Yip","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery Singapore General Hospital  Singapore"},{"name":"Duke\u2010NUS Graduate Medical School  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,8,24]]},"reference":[{"issue":"6","key":"e_1_2_8_2_1","first-page":"50","article-title":"Diabetic heel ulcers: a major risk factor for lower extremity amputation","volume":"50","author":"Younes NA","year":"2004","journal-title":"Ostomy Wound 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